Question

Which finding when reviewing the record of an elderly client would the nurse interpret as a normal occurrence with aging? A. Very concentrated urine B. Microscopic hematuria C. Occasional urinary incontinence D. Decreased glomerular filtration rate

Short answer

D. Decreased glomerular filtration rate

Step-by-step solution

Understand normal changes in the elderly

Identify normal physiological changes that occur with aging which may affect urine characteristics and kidney function.

Analyze the options in relation to aging

Evaluate each option to determine which one is a typical change related to the aging process.

Eliminate unlikely options

Rule out options that are not commonly associated with normal aging but could indicate a pathological condition.

Identify the normal occurrence with aging

Select the option which is most commonly recognized as a normal occurrence that aligns with the physiological changes encountered during aging.

Key concepts

Physiological Changes in the Elderly

As we age, our bodies undergo a variety of physiological changes that naturally affect various organ systems, including the urinary system. One prominent change in the elderly is the reduction in kidney size, particularly the cortical area which is responsible for filtering waste products from the blood. This decline may lead to a decreased glomerular filtration rate (GFR), a key indicator of kidney function. It is worth noting that a moderate decline in GFR is considered a normal part of the aging process and does not necessarily indicate a disease state.

Other changes that occur within the urinary system include a decrease in the elasticity of the bladder, potentially leading to issues like increased frequency of urination and occasional urinary incontinence. Additionally, the muscles surrounding the urethra weaken with age, which can also contribute to incontinence. Despite these changes, it is important to distinguish between normal aging effects and symptoms of urinary tract disorders which may require medical attention. Understanding these changes is imperative for caregivers and healthcare professionals to differentiate between normal age-associated adjustments and signs of potential illness.

Kidney Function and Aging

Kidney function declines as a part of the normal aging process. This gradual decrease is due to several factors, such as a reduction in the number of functioning nephrons, the tiny units within the kidneys that filter waste. As nephrons diminish over time, the whole kidney structure alters, reducing its ability to effectively filter the blood.

While a lower GFR is expected, there are also age-related changes in the tubules and renal blood flow, further impacting kidney function. The aging kidneys also have a reduced ability to concentrate urine, which could lead to issues like nocturia, the need to urinate frequently during the night. This physiological adaptation explains why option A from the original exercise, 'Very concentrated urine,' is less likely to be associated with normal aging, whereas option D, 'Decreased glomerular filtration rate,' is recognized as a typical change with age. To promote kidney health, elderly individuals are often encouraged to maintain regular hydration, monitor blood pressure, and follow a balanced diet.

NCLEX-RN Examination Preparation

Preparing for the NCLEX-RN examination requires comprehensive knowledge of human anatomy and physiology, including an understanding of how aging impacts body systems. To increase your chances of success on the exam, it's critical to study the physiological changes in the elderly, particularly how these changes can affect assessments, diagnoses, and expected outcomes in geriatric nursing care.

Reviewing the normal aging process as it relates to kidney function is crucial, as many questions may pertain to distinguishing normal age-related variations from pathological conditions. When preparing for the NCLEX-RN, students should prioritize learning about common geriatric syndromes, the implications of polypharmacy in elderly patients, and developing a strong foundation in age-specific assessments. Utilizing study resources that offer in-depth explanations and real-world scenarios can bridge the gap between theoretical knowledge and clinical application. By fully understanding concepts like those presented in the original exercise, future nurses will not only excel in their exams but also in their ability to deliver high-quality, informed, and empathetic care to the aging population.